Problem Statement Chapter-1&2

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    CHAPTER-1

    Introductions:-

    Good health depends in part on a safe environment clients in all health care

    setting are setting are at risk for acquiring infections because of lower resistance to

    infection microorganisms and invasive procedures

    Hospital-acquired infection also called Nosocomial infections are defined as

    defined as infections developing in the patients offer admission to hospital

    which were neither present nor in incubation at the time of hospitalization

    such infections may manifest during their stay in hospital some timer after the patient

    is discharged.

    In 1861 observed the association of puerperal sepsis with the attendants on

    patients by medical officers and students & he was successful to bring a dramatic

    reduction in infection rate by the introduction of hand washing with chlorinated

    line.

    After her experience of hospital acquired infections Florence night gale(1883)

    wrote in her book notes on hospital infection.. The very firstrequirement in a hospital that it should to the sick no harm. The actual mortality

    in the hospital, especially in those of large crowed cities, is very much higher than any

    calculation founded on mortality of the same class of disease among student

    treated outside hospital lord leister (1867) introduced his antiseptics surgery with the

    extensive use of carbolic acid.

    In ambulatory care facilities client may be exposed to pathogens, some of

    which may be resistant to antibiotics.

    In all settings the clients and families must be able to know the sources of

    infection and be able to institute protective measures clint teaching should include

    information concerning infections, mode of transmission, methods of prevention

    etc.

    The students can protect them form contact with infection material by having

    knowledge of the infection process & barriers protection. Understanding the chain ofinfection the (health care students workers) intervenes to prevent infection.

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    When the client acquires Nosocomial infection the student observer signs symptoms

    and takes appropriate action to prevent its spread. The course of an infection

    influences the `level of using care provided the incident of Nosocomial infection

    can be reduced when to the student practicing aseptic techniques.

    An analysis of laboratory findings providing information about students

    defense against infection by know the factors that increasing susceptibility or risk for

    infection students should be alert other healthcare team to the potential need for

    therapy and initiates supportive nursing measures.

    Patient in hospital are likely to get sick due to a new variety of micro

    organisms responsible for wide spectrum of hospital infection, bacterial isolates of

    mare resistant to standard antibiotic therapies, and a variety if health care providers

    directly involved in patient care. So, hospital has increasing become unsafe place for

    patient during their stay infection is a health hazard of great expanses and significance

    affecting the final outcome of treatment.

    Hence, it is the responsibility of to ensure an adequate arrangement to control

    the risk of infection since infection control is the quality standard of patient care it is

    essential well being of patients and safety of both students in a population alsoinfection control measure are to be viewed as a priority and have for be fully

    integrated into the continuous process of improvement of quality care.

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    NEED FOR THE STUDY

    An infection acquired in the hospital that was not present at the time of hospital

    admission

    Hospital acquired infections add over 7.5 million it result in approximately

    20,000 death and contribute to 60,000 more deaths yearly in the united states (Wilson

    et at 1991)

    Mortality rates may be as high as 25% far infection with some organisms. The

    estimated cost attributed to catheter related blood stream infection 3,700 to

    29,000 per case ( marvel 2000) incidence of Nosocomial infections in children varies

    by age and hospital unit, ranging from 0.2% to 23.5% in prospective cohort studies. A

    recent multicenter European study demonstrated on overall hospital

    Nosocomial infection rate of 2.5%, with the high est. rates in pedantries (23.5%)

    hematology units (8.2%), and neonatal units (7%) and the lowest rate in general

    pediatric units (1%). A second prospective cohort study of 4684 pediatric patients

    found the highest Nosocomial infection rates in children aged 23 months or younger

    (11.5%).

    Studies to determine the attribute morbidity, morbidity and cost of

    Nosocomial infection controlling for length of stay before infection, have not been

    performed in children.

    A study of 100 Nosocomial infections at the hospital for sick patients in

    estimated the attributable cost of Nosocomial infection at 12000 per patient 40% of

    patients with Nosocomial infection had morbidity attributable to the infection,

    including increasing length of stay and invasive procedures.

    Mortality was 11% among infected patients. Students have an important role

    in assess the Nosocomial infection and decrease incidence educating the students to

    understand the importance of hand washing and immunization in preventing the

    spread of disease cant be over emphasized. Hence we felt the need for improvement

    of student knowledge regarding prevention of Nosocomial infection.

    Hospital acquired (Nosocomial) infection (HAIS) increase morbidity,

    mortality and medical costs. In the USA alone, Nosocomial infections cause about 1.7

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    million infections and 99000 deaths per year. Approximately 15% of Nosocomial

    infections on the results of patient to patient transmissions of the causative organisms.

    During 100,781 patient days, 100,829 microbiological specimens from 24,362

    patients were sampled average investigation density: 1.0 sample per patient and day.

    The incidence density of 12.1 per 1000 patient days; range (6.2-16.6) were discerned.

    Approximately 15% of Nosocomial infection are the result of the cross

    transmission of causative organisms between patients. The present study attempts to

    correlate a measure of adherence to standard infection control i.e., the rate of bacterial

    cross transmission.

    An estimated 2 million patients develop Nosocomial infections in the united states

    annually. The increasing number of antimicrobial agent. Resistant pathogens and high

    risk patients in hospitals are challenges to progress in preventing and controlling these

    infection we identified 631 infections in 498 patients on average only57% of the

    infections were properly recorded and cooled in the discharge abstract.

    Over 1.4 million people worldwide are suffering from HAIS or Nosocomial

    infections as they are called. In India Nosocomial infection rate is at over 25% and it

    is responsible for more mortality than any other form of accidental death.

    36.2% infection was found per 1000 patient day in the hospital acquired

    infections were reported in58 patients out of 100, the extent of ventilator associated

    was found to be 30.7% per1000 ventilators days.

    Incidences of infection control groups range of from 5% to 85% moreover, the

    incidence of ventilators associated in the control groups varied from 5% to 85% the

    incidence of disease is 50% lower on average. The calculated rate is studies from 0.43

    to 1

    The mortality in the control groups in these studies varied from 10% to 58% in

    all studies. It was only the mortality of patients which they remained in the hospital

    that was assessed.

    Mortality demonstrate by orderly 20% and in the varied from 0.52(95% to

    0.12-0.92). the reduction in mortality in these analysis was 20% and 40% when onlystudies with patients were analyzed.

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    The reports that between 1990 and 1996 and coil, staphylococcus aureus and

    Enterococci were the most common infecting organisms of Nosocomial infection

    every year while hospitalized.

    Approximately 240,000 additional residents of long terms care facilities

    become infected each year, with anticipated growth of population this may increase to

    750,000 by 2005. We identified 631 infections in 498 patients on average only 57% of

    the infections were properly recorded the 217 patients enrolled, 201 were included in

    the final analysis, seventy seven (38.5%) patients developed one or the other

    infection.

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    CHAPTER-II

    1. Problem statement:-A study to assess the knowledge regarding prevention of Nosocomial

    infection among GNM students in Sri Krishna Chaithanya School of

    Nursing of Madanapalli.

    2. Objective:- To assess the knowledge of GNM students regarding prevention of

    Nosocomial infection.

    To prepare & provide health education module of Nosocomialinfection

    3. Operational definitions:-Assess : - The ability to evaluate knowledge of students.

    Knowledge : - Refers to awareness of students in selected areas

    at Madanapalli.

    Nosocomial infection: - It is also called hospital acquired infections; it is

    defined as infection occurring in admitted hospital.

    Prevention : - In this study it refers of an action which taken

    Before the occurrence of Nosocomial infection.

    Self instruction module : - It refers to personally to provide informed for the

    life style

    Assumptions :-

    Students may be willing to express their knowledge regardingprevention of nosocomial infection.

    Students may have some knowledge regarding prevention ofnosocomial infection.

    Health education module will improve the knowledge.

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    Limitations :-

    The study is limited to

    Who are willing to participate in the study? Who are available during the study?

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    CHAPTER-III

    1. Review of Epub 2011, Jan 25:-

    Hospital acquired infections are spread by numerous router including surfaces

    especially hands air, water, intravenous routes, aril router and through surgery

    multiple infection control techniques and strategies simultaneously may offer the best

    opportunity to reduce the hospital acquired infection most of these infection control

    strategies will mark then pay for themselves by saving the medical costs associated

    with Nosocomial infection.

    2. Review of Difillippo 2009:-

    over the last 5years clinical traits in vesting action product procedures and

    treatments aimed at preventing infection in the hospital have been described the

    findings of these studies appear to confirm the effectiveness of certain preventive

    procedures with regard to ventilate associated pneumonia the efficacies of

    decontamination of the all parts all these procedures can be incorporated into

    departmental protocols for the prevention Nosocomial infections in the hospital level

    A systematic review of the hand washing:-

    Hand washing is improved by incising the ration of the number of sinks as

    hand cleaner Dispenser to beds provided automated water appears not to increase

    hand washing rates compared to traditional non automated sinks a combination of bed

    side antiseptic hand rub dispensers and posters to remind staff to an improvement in

    health care workers hand washing compliance glove use was shown to diminish

    compliance with pre care hand washing by a much as to prevent infection.

    3. Review of reducing hospital acquired infection by design Wilson (2006)

    A study of the planning and building of new hospital to reduce infection by design

    they tried to make hand basics were placed as the window all in front at approaching

    staff and one the peninsula units alcohol hand get was also planned for every bedside

    hoverer, they did not evaluate the impact of their design on infection control.

    4.Review of Vietri-2004:-The effect of moving to a new hospital facility on the

    prevalence on methicillin resistant Staphilococcus aureus the design of the newfacility is much more conductions to the performance of good infection control for

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    example ward beds are segregated into 1-4bed rooms with a sink at each room

    entrance each with at least 2 dedicated sinks Radical facility design changes, which

    would be permissive of optimal infection control practices, were not sufficient, by

    themselves to reduce the Nosocomial spread of infection.

    5. Review of MC Gaskin (2006): The effect of random voice hand hygiene massages

    delivered by medical, nursing and infection control staff in hand hygiene compliance

    in care. Intensive

    - They found that using random voice message increased hand washing compliance.- Twelve voice messages on hand washing compliance facts such as hand hygiene

    should occur before and after patient contact, and soon well installed to deliver

    prompts to 2 amplified external speakers.

    6. Review of Lesson Etal,(2005):- Effect of antiseptic hand washing, alcohol

    sanitizer on healthcare associated infectious in neonatal intensive care units.

    - Tow hand hygiene products were a traditional antiseptic hand wash and an

    alcohol hand sanitizer.

    - Each product was used for 11 consecutive months in each neonatal intensive

    care unit in random order.

    - These were no significant difference in neonatal infections b/n the two products.

    -The skin condition of participating nurses was significantly improved during the

    alcohol phase (p=.02 and p=.049 for observes and self elements, respectively), but

    these were no significant deference in mean microbial counts on nurses hands.

    - How raining the impact on infection rats of a single intervention is challenging

    became of multiple contributory factors such as patient risk unit design, and staff

    behavior other practices such as quality of hand hygiene are likely to be as important

    as product in reducing vise of cross transmission.

    7. Review of surveillance data of nasocomial in reducing risk of cross

    transmission.

    Siena Barwolff, MD.2010:-

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    Roles of increasingly used for public reporting and inter hospital

    comparisons. These exogenous infection could be prevented by adherence to basic

    infection control misers measurements and main results primary isolator of six

    indicator organism (acinetobacter Baumann, enterococcus facility and fascism,

    klebsiella pneumonia, pseudo staphyio coccus cures) cultured from clinical samples

    or methicillin resistant soured surveillance testing of all in patients were

    genotyped.indistiuguishable isolates in >2 patients defined potential episodes of

    transmissions surveillance of Nosocomial infection rates was performed according to

    the Nosocomial infection rates was performed according to the germen hosocomial

    infection surveillance system, kvankenhaus infections surveillance system,

    kvankenhaus infection rates was performed. According to the germen hosocomial

    infection surveillance system differences in nasocomial infection rate by cross

    transmission

    8. Review of efficiency of Nosocomial infection control

    Robestw. Helcy 1993 October:-

    With the emergence of Nosoconial infection as a serious problem among us hospitals,

    the centers for disease control under took in 1974 a nationwide study to evaluate

    approaches to infection control. The three phased project now known as the study on

    the efficacy of Nosocomial infection control or senic project was designed with three

    primary objectives.

    To determine whether land id so to what degree the implementation of infectionsurveilance and control programs (ISCPS)has lower the rate of Nosocomial

    infection.

    To describe the current status of ISCPS and infection states To demonstrate the relationship among characteristics of hospital and patients

    components of ISCPS and changes in the infection rate with data collection

    completed in a nationality representative sample of hospitals and to point out

    additional specific questions to be answered by future research.

    9. An overview of Nosocomial infection including the role of the micro bilgy

    laboratory TGEMORI move and gayner 1987 may.

    An estimated 2 million patients develop Nosoconial infections in the united statsannually the inarching number of anti microsobial agent resistant pathogens and

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    high-risk patients in hospitals are challenges to progress in preventing and controlling

    these infections.

    While Escherichia coli and Staphylococcus aureus remain the most common

    pathogens is lasted overall from Nosocomial infection coagulase negative

    staphylococci organisms previously considered contaminats in most culture are now

    the predominate pathogens in blood stream infection the growing number of

    antimicrobial agent resistant organism is trouble some particularly vancomycin

    resistant Enteroccous and pseudomonas auruginosa resistant to imipinem. The active

    involvement and cooperation of the microbiology laboratory are important to the

    infection control program particularly in surveillance and the use of laboratory

    services for epidemiologic purpose.

    10. Review of Reliability of Report Nosocomial infections RM Manssanasi,

    Kwilkesson October 27,2004

    Proper reporting of discharge diagnoses, including complications of medical

    care is essential for maximum recovery of revenues under the prospective

    reimbursement system. To evaluate the effectiveness of abstracting techniques in

    identifying Nosocomial infection at discharge, discharge abstracts of patients with

    Nosocomial infections were reviewed during September through November of 1984.

    Patients with Nosocomial infections were identified using modified centers for

    disease control (CDC) definitions and trained surveillance techniques. Although these

    lost revenues are substantial, they constitute but a small proportion of the potential

    costs to the institution where patients acquire Nosocomial infections.

    11. Review of an Indian experience Dheeraj Gupta, MD, Ritesh Aggarwal.

    There is a paucity of data on Nosocomail infection in India . we determined

    prevalence pattern risk factor and outcome of infections acquired inpatients admitted

    to our respiratory intensive care unit.

    Data on RICU acquired infection were collected prospective over a15 month

    period the presence of risk factor such as endotracheal intubation, surgical drains,

    renal failure, diabetes mellitus, malignancy immunosuppressive therapy were

    evaluated in patients who developed infections used univarite and multivariate

    logistic.

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    Infections acquired during hospitalization prolonged ICU stay but had no

    effect on ICU survival.

    12. Review of PGI plans to control hospital acquired infection Aditipaddon

    tribune news service.

    Chandigarh July 29

    Rising to the challenge posed by hospital acquired infection (HAIS) which are

    emerging can global health concern, the PGIMER today reiterated its commitment

    reducing that risk at the tertiary care institute.

    Like other hospitals of the world, the PGI is not out of bounds for HAIS which

    have been found to be prevalent an in infection care committee of the PGI through

    active surveillance has accumulated the following. Data pertaining to HAIS at the

    institute .

    Dr. A.K. Gupta aggress, it is tenacious to eradicate HAIS. It is more

    expensive more prolonged and results in the wastage of hospital resources. Excessive

    use of antibiotics must also be avoided. There in appropriate and over use leads to

    growth of drug resistant organisms.

    13. Reviews related to Foreign Literature Katrena Wells (2009) in her article.

    Best ways to prevent Nosocomial infection suggests five ways to help prevent

    the spread of infections in hospital these are hand hygiene, avoiding infecting others if

    you are sick using a tissue when you cough or sneeze ensuing should be sanitized

    before they touch your skin.

    Others methods of preventing Nosoconial infection include observance of

    antiseptic technique frequent hand washing especially between patients careful

    handling cleaning and disinfection of fomites air filtration with in the hospital, and of

    single use disposable items.

    14. Reviews related to hospitals may bring diseases and infections Smith, Tohn

    2009.

    Hospitals may bring diseases and infection to students while attending to all

    the patients needs because they are the primary attending to all the patients need

    because they are the primary care gives of patients and are more in contact with thepatients. Preventive measures are being implemented for the pts and to the students as

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    well as in order to prevent Nosocomial infection some precautionary measures must

    be implemented in the event of any social conflict with in the area like using gloves as

    a protective gear to prevent transmission of diseases from patients on to the student

    and proper hand washing .

    15. Reviews related to hand washing by health care worker john Bosso (2004)

    Hand washing by health care workers in crucial in preventing and

    controlling the spread of Nosocomial infection only through staff education and

    awareness ongoing surveillance and appropriate in tervention can this can problem be

    alleviated.

    16. Reviews related to preventing the spread of disease Maggie Edgar(1996)

    Tips for provide stated that care providers can stay healthier by following

    these guidelines wash hands properly and frequently maintain current immunizations

    especially tetanus like scheduled breaks and vacations observe good nutrition exercise

    regularly rest sufficiently each day and engage in hobbies or other activities that do

    not involve caring for someone else care providers who are ill should take care and

    they can spread germs to others. A health care provider is the key to a healthy. Happy

    client care experience for clients and their families.

    17. Reviews related to conducted a study entailed a study of students

    Bridger(1997)

    Conducted a study entitled a study of students views about the Nosocomial

    middle university royal free hospital at London, UK. this study sought to discover the

    contribution of students practice to the prevention of hospital acquired an

    Nosocomial urinary tract infection (NUTIS) the most commonly Nosocomial

    infection this qualitative study utilized unstructured interviews to explore the views of12 registered students about three key issues first what care do study give with the

    aim of preventing catheter associatiated NUTIS secondly.

    18. Reviews related to entitled Nosocomial infection Handwashing compliance.

    Comparing hand hygiene protocols sensor operater faucetsavets evidence

    for knowledge this study was conducted in the mediam sized the hospitals and

    educational institutions the examine the e effect of appropriate quality management

    activities on Nosocomial infection rates during a 26 month period the study focus on

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    medical department and were included to capture data for students requiring this type

    of treatment after any surgery the result was mainly aware of opportunities to use

    quality improved and survival activities as strategies to reduce the risk of infection.

    19. Hand washing program for the prevention of Nosocomial infection

    Saupin won etal (2004): hand washing program for the prevention of

    nosocomial infection in the ward that was held at a level III in teaching hospital. The

    participate are statement in the word and the objective of this study is to evaluate

    effecte of a hand gygiene program on compliance with hand hygiene and the rate was

    asocddiated with a significance decrease in rated of nosocomial infection in particular

    and that washing rate of nosocomial infection in particular and that washing hand is a

    simple economical effective method.

    20.Extensive epidemiological surrey of the microbilogical monitoring of the

    student

    Torregrossa M.V retention cocchiarap (2000) prevention of hospital.

    Ocquired infection in the patient cente this study reports on an extensive

    epidemiological survey this study reports on an extensive epidemiological surrey of

    the microbiological monitoring of the environments students the aim of the survey

    was to evaluate the presence and distribution of environmental sources of nosocomial

    infection in immunocompromised hostes strains strains collected from air tap water

    and medical and were compared with strains isolated from infection to student the

    potential route of batleria the nesults showed environment strains present ion a

    profice identification to that the clinical strans suggesting alink between the student

    and other.

    21.Reviews related to treatment in a hospital or a health care unit according to

    narciso D.Santiago.

    Nosoconial infection is a result of treatment in a hospital or a health care

    service unit but secondary to the patients original condition, it is a hospital acquired

    infection or more generally know as health care associated infection that is

    responsible for the large number of death in the word hand washing and improving

    hygiene praction in the hospital is the effective way for teducing the wpread of there

    infections.

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    22.Reviews related to hospital acquired infection disclouse act of 2009

    according to (camero. Jazmin,20009):-

    Hospital acquired infections disclosure act of 2009 requires all hospetals to

    submit a yearly report of all the collected data regarding hospital acquired infection

    care to the department of health then the will submitted by the hospitals.

    The department of health shall also appoint members of the advisor y

    committee which includes the physicians representation of infection control

    department of both private and public hospital academic research epidemiologists

    health maintenance organization and health insures who will help the department

    formulate and establish standards rules and regulations needed to execute this bill.

    23.Reviws related to surveillance is the close and continuing observation

    individual or group, according to tessa tan tores ,M.D :-

    Its goal, in the hospital is the collection of accurate reliable and timely data on

    infection and modifiable diseases acquired with in the hospital surveillance data also

    includes information on risk factors etiologic agents and antimicrobial susceptibility.

    The specific aims of sur of surveillance are the following.

    Detect the areas of concern in terms of infection control.

    Identify potential epidemics. Anis and consider the effectiveness of infection control measures. Remind the personnel about the infection control practices. Give and provide about for comparison with other services.

    Surveillance of nosocomial infection is not a control measures by it self and

    the present of ICC personal can possible lead to stricter adherence on infection

    control practices among the hospital staff.

    24.Reviews related to hoscomial infection convince to be of major clinical and

    epidemiogical importacnce. According to hillippine journal of micro biology and

    infection disease:-

    It is was stated that nosocomial infection continues to be major clinical and

    epideniologcal importance and this night be because of the continuous incidence of

    transmission of hosocomial infection which is great improper delivery of health this

    kind of infection develops during a clients confinement at the clinical facility. But not

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    also that is can be mainfected even affer cient is also that is can be manifested even

    after the client is discharge moreoves nosoconical infection are not clinical to patents

    but also the health care works can also acquire this situation which usually give

    asigunifiction effect on the health works life style.

    25.Reviews related to health care works knowledge skills and attitudes for good

    infection control practices according to katz ss.MD 2009:-

    Health care works should be equipped with control practices the infection

    control team should an training needs of the staff and provide required training

    through awareness programs in service education and on the staff for essential

    infection control practices that are appropriate to their job description provided

    periodic re-training or orientation of staff and reiew the impact of training.

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    CHAPTER - IV

    METHODOLOGY

    This chapter deals with the research, research design, setting of study, variables,

    Population, sample size, sample, sampling technique, criteria for sample selection,

    description of the tools, and procedure for data collection and plan for data analysis.

    Research approach:-

    An evaluative approach was used for the present study.

    Setting of study:-

    The study is conducted in Sri Krishna Chaithanya School of nursing at

    Madanapalli.

    Variables:-

    Dependent variable is the knowledge on prevention of Nosocomial infection.

    Attribute variable

    Sample :- The sample of the present study was students who full fill inclusion criteria.

    Sample :-the sample size is 25 samples

    Sampling Technique:- the purposive sample technique is used to select the sample

    Criteria for sample selection

    a) Inclusion Criteria :students who are available at the time of study

    students who are willing to participate in study

    b) Exclusion Criteria:Students who are not available at the time of study

    Students who are not interested and willing to participate in the study.

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    Population: in the present study the target population comprised of students the

    accessible population in this study were students those who fulfill the inclusion

    criteria during time of data collection.

    NOSOCOMIAL INFECTION

    Introduction of Nosocomial infection:-

    There is no hospital however small, air or well ventilated, where the epidemic

    under is not to be found of times, and thus no operation dared to be performed. Every

    cure stands still, every wound becomes acre and every sore is gggg to run into

    gangrene. But in great hospitals specially, it prevails at all times and is a real

    gangrene. The term nosocomial infection that was neither present gggg was in its

    incubation period when the patient entered the hospital. Nosocomial infection may

    also make their appearance after discharge from the hospital, if the patient was in the

    incubation period at the time of discharge.

    In the united states centers the centers for disease control and prevention

    estimate that roughly 1.7 million hospital associated infections, from all types of

    micro organisms, the mortality and morbidity rate is increased, the nosocomial

    infection is among the most difficult problems confronting clinicians who deal with

    severally in patients.

    Definition:-

    A hospital acquired infection also called a Nosocomial is an infection that first

    appears between 48hours and four days after a patient is admitted to a hospital or

    other health care facility.

    Causes: - All hospitalized patients are at risk of acquiring an infection from their

    treatment or surgery. Some patients are at greater risk than others, especially young

    children.

    Prolonged hospital stay. Severity of underlying illness. Compromised nutritional or immune status.

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    Use of individually characters Failure of health care workers to wash their hands between patients or before

    procedures.

    Bacteria Some common procedures that increase the risk of hospital acquired infections

    include.

    Urinary bladder catheterigation. Respitatory procedures such as incubation as mechanical ventilation. Surgery and the dressing are drainage of surgical wounds. Intravenous (IV) procedure for delivery of medication transfuction or

    nutrition.

    Symptoms:-

    Fever is often the first sign of infection. Other symptoms and signs of infection are rapid breathing, mental confusion,

    low blood pressure, pain reduced urine output, and a high white blood cell

    count. Patients with a UTI may have pain when urinating and blood in the

    urine.

    Symptoms of pneumonia may include difficulty breathing and inability tocough.

    A Canalized infection begins with swelling, redness and tenderness on the skinDiagnosis:-

    Infection is suspected any time a hospitalized patient develops a fever that

    cant be explained by the underlying illness. Some patients, especially the elderly,

    may not develop a fever, In these patients. The first signs of infection may be rapid

    breathing or mental confusion and inflammation.

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    Diagnosis is determined by:-

    Evaluation of symptoms and signs of infection. Examination of wounds and catheter entry sites for redness, swelling or the

    presence of pus or on abscess.

    A complete physical examination and review of underlying illness. Laboratory tests, including complete blood count (CBC) especially to look for

    an increase in infection fighting white cells.

    Urinalysis looking for white cells or evidence of blood in urinary tract,cultures of the infected area, blood, sputum, urine or other body fluids or

    tissues to find the causative organism.

    Chest x-ray may be done when pneumonia is suspected to look for thepresence of white blood cells and other inflammatory substances in lung

    tissue.

    Review of all procedures performed that might have led to infection.Management:-

    Treatment:-

    Cultures of blood, urine, sputum, other body fluids, or tissue are especially

    important in order to identify the bacteria, fungi, virus, or other micro organisms

    causing the infection.

    Once the organism has been identified it will be fasted again for sensitivity toarrange of antibiotics so that the patient can be treated quickly and effective organism

    will respond. While waiting for these test results treatment may begin with common

    broad spectrum antibiotics such as penicillin, cephalosporins, Tetracyclines, or

    erythromycin when patients with chronic illnesses are frequently given antibiotic

    therapy for long periods of time. Two strong antibiotics that have been effective

    against resistant bacteria are vancomycin and imipenem.

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    Fungal infections are treated with antifungal medications.Examples of these are amphotericin B.

    Viruses do not respond to antibiotics. A number of antiviral drugs havebeen developed that slow the growth or reproduction of viruses, such as

    acyelonor, ganciclovir, amantadine.

    Prevention:-

    Hospitals take a variety of steps to prevent nosocomial infections, including. Adopt an infection control program such as the on sponseaed by the centers

    for disease control which includes quality control of procedures know to lead

    to infection.

    Identify high risk procedures and other possible sources of infection. Strict adherence to hand washing rules rules by health care workers and ration

    of procedures including use of sterce gowns, gloves masks and barriers.

    Sterilization of all reusable equipment such as ventilation humidifiers, and anydevices that come in contact with the respiratory tract.

    Frequent changing of dressings for wounds and use of antibacterial ointmentsunder dressing.

    Prevent contact between respiratory secretions and health care providers byusing and masks as needed.

    Isolation of patients with known infections Sterilization of medical instruments and equipment to prevent contamination

    Reduction in the general use of antibiotics to encourage better immune

    response in patients and reduce the cultivation of resistant bacteria.

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    CHAPTER-V

    RESULTS DATANALYSIS

    This chapter deals with the analysis and interpretation of data collected from

    25 students in Sri Krishna Chaithanya School of nursing at Madanapalli in order to

    assess the knowledge of selected GNM students regarding prevention of Nosocomial

    infection.

    Prevention of Nosocomial infection:-

    The data collected were analysis which includes descriptive statistics. The data

    finding has been tabulated according to the plan for data analysis and interpreted

    under the following objectives.

    To assess the level of knowledge regarding prevention of Nosocomialinfection.

    To find association between the findings with selected demographic variables.Presentation of data:-

    The analysis of data is organized and presented under the following sections.

    Section A: - Demographic variables of selected GNM students.

    Section B: - Assessment of level of knowledge of selected GNM students.

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    FREQUENCY AND PERCENTAGE DISTRIBUTION OF

    DEMOGRAPHIC VARIABLES

    S.N DEMOGRAPHIC DATA FREQUENCY PERCENTAGE

    1 Age

    a) 17-20 years 21 84b) 20-23 years 2 8c) 23-26 years 2 8

    2 Religion

    a) Hindu 17 68b) Christian 6 54c) Muslim 2 8

    3 Educational Status

    a) 1st GNM 13 52b) IIn GNM 12 48c) IIIr GNM 0 0

    4 Place of residence

    a) Rural 12 48b) Urban 13 52c)

    Slums 0 0

    5 Source of information

    a) Mass Media 3 12b) Teachers 9 36c) Friends 13 52

    The Table-1

    Shows that out of 25 sample car people 21(84%) student were in the age group of 17-

    20 years, followed by 2(8%) students were in the age group of 20-23 years, followed

    by 2(8%) of people were in the age group of 23-26 years.

    In religion 17(68%) were Hindus and 6(24%) were Christians and 2(8%)were Muslims.

    Education status shown that majority of student 13(52%) had first GNMstudents 132(48%) had second GNM student and (0.0%) 3

    rdGNM student.

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    Place of residence shows that maximum students 13(52%) belonged to urbancommunity and 12(48%) belongs to rural community 0(0.0%) students

    belongs belongs to slums.

    Soured of information showes that 13(52%) student get information throghteacher 3(12%) had got infarmation through mass media.

    Table-2

    Knowledge level Ranging Frequency Percentage

    Inadequate

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    AGE

    Percentage Distribution Of Students According To Age

    84

    8 8

    0

    10

    20

    30

    40

    50

    60

    70

    80

    90

    17-20 years 20-23 years 23-26 years

    Age

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    RELIGION

    Percentage Distribution Of Students According To Religion

    68

    54

    8

    0

    10

    20

    30

    40

    50

    60

    70

    80

    Hindu Christian Muslim

    Religion

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    EDUCATION

    Percentage Distribution Of Students According To Education

    0%

    20%

    40%

    60%

    80%

    100%

    1st GNM

    IInd GNM

    IIIrd GNM

    5248

    0

    Education

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    PLACE OF LIVING

    Percentage Distribution Of Students According To Place Of Living

    48%

    52%

    0%

    Palce of Living

    Rural

    Urban

    Slums

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    SOURCE OF INFORMATION

    Percentage Distribution Of Students According To Place Source

    Of Information

    0

    10

    20

    30

    40

    50

    60

    Mass Media Teachers Friends

    12

    36

    52

    Source of Information

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    CHAPTER-VI

    The Chapter Deals with the discussion of findings of data analysis. The

    statement of the problem was a study to assess the knowledge regarding prevention of

    Nosocomial infection among GNM students in Sri Krishna chaithanya school of

    Nursing at Madanapalli.

    The highest mean knowledge noticed in the aspect of [retentive

    measures(18.12),followed by treatment (14.4%)introduction (3.84),Diagnosis(4%),

    symptoms(6.88), causes(5.76) and least knowledge found on causes(3.84)(highest to

    lowest).

    The overall knowledge among people rereals that (48%) of the respondents

    had in adequate knowledge(32%) of the respondents had moderate knowledge and

    (20%) of the respondents had adequate knowledge.

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    CHAPTER-VII

    CONCLUSION

    The chapter present the conclusions drawn, implications, limitations,

    recommendation and delimitations. The focus of this study was to evaluate the

    knowledge regarding prevention of Nosocomial infection among GNM students in

    terms of knowledge regarding selected aspects of prevention of Nosocomial infection

    in Sri Krishna Chaithanya school of nursing at Madanapalle.

    The major findings of the study knowledge among people on the selected

    aspects of prevention of flurosis. There is no significant association between the age

    and knowledge level of respondents on the aspect of prevention of Nosocomial

    infection. There is no significant association. There is no significant association

    between knowledge level and demographic variable viz. Religion of students.

    Nursing implications:-

    The findings of the study can be used in the following areas of nursing

    profession.

    Nsg education:-

    The nursing curriculum should consists of increased depth, content and

    activities which helps to develop skill of nurses in prevention of Nosocomial

    infection among students, As a nurse educators there are an abundant opportunities

    for nursing professionals to educate the students regarding selected aspects of

    Nosocomial infection. The nurse should educate about the utilization of local health

    services and voluntary health agencies assistance, which helps to promotes health of

    people.

    Nursing practice:-

    Nurses are the key persons of the health team who play a major role in

    effective health promotion and maintenance. Nursing care is an art and science in

    providing quality care.

    Nursing international program can be used as a teaching strategy in the

    hospital as well as in the community, i.e. Though radio, television, documentary

    films, pamphlets, leaf lets etc.

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    Nsg Administration:-

    The nursing administration can take part in developing protocols, standing

    orders related to designing the health education program me to update nursing

    personal knowledge regarding prevention of Nosocomial infection. The nurse

    Administrator should take interest in providing information on selected aspect of

    Nosocomial infection. The nurse administration should plan and organize continuing

    education program for the faculty of nursing school and colleges to organize the

    comparing on the knowledge regarding prevention of Nosocomial infection among

    GNM students.

    Nurse research:-

    This study helps the nurse researchers to develop a propriety health education

    tools for educating the people regarding selected aspects of prevention of nosocomial

    infection according to their demographical characteristics nurse should come forward

    to take up unsolved aspect in the field of nosocomial infection to carry out studies and

    public them for the benfit of patients public and nursing fraternity. The public and

    private agencies should also encourage research in this field through materials and

    funds.

    Recommendations:-

    On the basis of the finding of the study following recommendations have

    been mode

    - A similar study can be replicated on a small sample to generation the findings- A student can be conducted by demographic variable.- Self instructional modules may be develop in all dimensions and aspects of

    prevention of noscomial infection.

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    Chapter- VIII

    SUMMARY

    Nosocomial infection is naturally occurring substance found in other crest it is

    found in natural water supply in earth crest it is found in natural water supply it causes

    serious problem among people many going people affected by server nosocomial

    infections.

    The main aim of this study was to evaluate the knowledge rearding prevention

    of nasocomial infection among GNM student.

    Objectives of the study :- To assess the knowledge regarding prevention of

    nosocomial infection among GNM students to assess the knowledge level with

    selected demographic variable.

    The find findings of the student were related to the knowledge scoures on

    selected aspects on prevention of nosocomial infection among GNM students. Over

    all mean knowledge are 56.48 the highest mean found in preventive measures (16.16)

    and least mean found in curses.

    The knowledge noticed according to aspect wise adequate knowledge (76%)

    responders had moderate knowledge and respond ants had in a adequate knowledge

    about the infection and definition of noscomial infection.

    The responders had adequate knowledge had moderate knowledge and had

    adequate knowledge regarding causes of nosomial infection on, the knowledge

    noticed 9(36%)respond ants had adequate knowledge12 (48%) respondents had

    moderate knowledge and 4(16%) respondents had inadequate knowledge regarding

    biagnosis of nosocomial infection.

    The knowledge noticed 5(20%) respondents had adequate knowledge 13(52%)

    respondents had moderate knowledge and (28%) respondanty had moderate

    knowledge regarding of nosocomail infection the knowledge 14(56%) resposdants

    had ad equate knowledge 14(56%) respondents lad quart knowledge and 6(24%)

    respondants had inadequate knowledge regarding prevention of noscomail infection.

    The are all mean knowledge is the aspects of introduction causes symptoms

    8.48 dig noses 8.48,treatment 9.44 and preventive measures 16.16.